America's Children and the Environment (ACE) is EPA's report on data related to children's environmental health. ACE brings together information from a variety of sources to provide national indicators, which are easy-to-understand summaries of data from national surveys and studies. The indicators are grouped into the following areas:

Environments and Contaminants (conditions in the environment, such as levels of air pollution)

Biomonitoring (contaminants measured in the bodies of children and women of child-bearing age, such as children's blood lead levels)

Health (rates at which certain illnesses or conditions occur among U.S. children, such as the annual percentage of children with asthma)

Each indicator is accompanied by background text that describes how the issue is relevant to children's environmental health, along with a description of the data used in preparing the indicator. Wherever possible, the indicators are based on data sources that are updated in a consistent way, so that indicator values may be compared over time.

This website presents indicators included in the third edition of ACE (referred to as ACE3), which was originally published in 2013; previous editions of ACE were published in 2000 and 2003.

First, it brings together data from a variety of sources to show trends and other information on important factors relevant to the environment and children's health in the United States.

Second, it can inform discussions among policymakers and the public about how to improve data on children's health and the environment.

Third, it includes indicators that can be used by policymakers and the public to track trends in children's environmental health, and ultimately to help identify and evaluate ways to minimize environmental impacts on children.

EPA believes information on trends in children's environmental health is valuable and should be shared with the public. The purpose of ACE is to compile, and make available to a broad audience, information that can help identify areas that deserve more attention, potential issues of concern, and persistent problems. Some of the indicators can also be used to help evaluate whether past environmental policies and actions have been effective. EPA hopes that these indicators will motivate more research and data collection, and, when appropriate, action to address problems.

The information in ACE should not be used as the only basis for planning or policy making. EPA and other federal agencies use information from many different sources when planning their activities on children's environmental health. ACE presents findings from many studies, but ACE isn’t meant to be an authoritative summary, nor does it represent a conclusion about the weight of scientific evidence.

ACE defines an indicator as “a quantitative depiction of an aspect of children’s environmental health that summarizes the underlying data in a relevant, understandable, and technically appropriate manner.” Simply put, the indicators in ACE present numerical data from surveys and studies in an easy-to-understand format. The data may represent environmental conditions, chemicals in the bodies of children and women of child-bearing age, or the frequency of certain childhood diseases and conditions. Federal data on children’s environmental health issues come from several different agencies and are often very detailed and complex. ACE brings this information together into one report and summarizes the data in graphics that convey the key information. The ACE indicators focus on presenting data at the national scale in order to meet its three main objectives, described above.

ACE3 uses the terms “children’s environmental health” to refer to the external physical, chemical, and biological factors that affect—or could affect—children's health. The evidence of relationships between environmental exposures and children’s health continues to evolve for many of the indicators presented in this report. Just because an indicator is included in ACE3 does not necessarily mean there is a known relationship between the environmental exposure and an effect on children’s health. EPA aims to develop increasingly informative indicators of children’s environmental health as more data become available to reduce these uncertainties.

Environmental contaminants can affect children quite differently than adults, both because children may be more highly exposed to contaminants and because they are often more vulnerable to the toxic effects of contaminants.

Children generally eat more food, drink more water, and breathe more air relative to their size than adults do. That means they may be exposed to relatively higher amounts of environmental contaminants. Children's normal activities, such as putting their hands in their mouths or playing on the ground, can result in exposures to chemicals that adults do not face. In addition, some environmental contaminants may affect children more than adults because their bodies are not fully developed and their growing organs can be more easily harmed.

How did EPA select the topics and indicators in the third edition of America's Children and the Environment (ACE3)?

In choosing indicators for ACE3, EPA considered factors such as public interest, the extent of exposure, the number of children experiencing an illness or condition, the severity of health outcome, past EPA actions to address the issue, and research showing or suggesting that an environmental exposure may affect children's health.

ACE3 includes updates and revisions to topics and indicators previously included in the 2003 ACE report, as well as new topics and indicators. Topics were selected by first preparing a list of children's environmental health issues, then evaluating the availability of data relevant to those topics, and considering indicators that might be derived from the data. EPA obtained input from members of EPA's Children's Health Protection Advisory Committee (CHPAC) on each stage of this process. EPA also obtained input from independent peer reviewers regarding the suitability of the indicators and other information provided for each topic. EPA revised the report based on the peer review comments, and comments received from the public.

Federal agencies provided the data for most of the indicators. The data for the Environments and Contaminants indicators are generally from data systems maintained by EPA and by state environmental agencies. Data on indoor lead hazards are from surveys conducted by the U.S. Department of Housing and Urban Development. Pesticide residue data are from the Pesticide Data Program of the U.S. Department of Agriculture. Data on the levels of contaminants in the bodies of children and women of childbearing age, as well as data on childhood illnesses and conditions are from the National Center for Health Statistics in the Centers for Disease Control and Prevention. Cancer data are from the National Cancer Institute. Child population data from the Census Bureau were used for calculations in several of the Environments and Contaminants indicators.

Data for the Supplementary Topics measures are from targeted efforts that provide information on an aspect of a children's environmental health issue for which more comprehensive data are not available. Childcare facility measures are derived from a national study, and from a study in North Carolina and Ohio. For schools, EPA developed a measure on indoor pesticide application based on data reported by California schools to the California Department of Pesticide Regulation. The data on birth defects are from the Texas birth defects monitoring program. Data from individual states are not meant to describe national conditions or conditions in other states.

There were 74.2 million children ages 17 years and younger in the United States in 2010. The age range used for each ACE3 indicator depends on the availability of data for different age ranges and the nature of the topic being addressed. Each indicator includes the age range in the title of the figure.

ACE3 presents (where possible) indicators for groups of children of different races and ethnicities and for children living in households with different levels of income. In some cases, these breakouts by race/ethnicity and family income are shown in the graphs, while in other cases they are included in the data tables. The specific race/ethnicity categories used for each indicator depend on the source of data, and are discussed in the introduction to each section of the report.

Many of the indicators also provide separate indicator values for children living in homes with family income below poverty level and those in homes at or above poverty level. “Poverty level” is defined by the federal government and is based on income thresholds that vary by family size and composition. In 2010, for example, the poverty threshold was $22,113 for a household with two adults and two related children.

ACE3 aims to include indicators that present trends over at least 10 years. When data are not available to show changes over time, indicators show the most current data available, often comparing race/ethnicity and income. Some topics include both a trend indicator and a separate indicator with race/ethnicity and income comparisons using current data. All ACE3 indicators incorporate the most current data that were available at the time of analysis.